Thrombolysis in Stroke

Thrombolysis in stroke represents a break, through clots and nihilism.¹Although thrombolysis can only be recommended for a minority of patients and under the strictest circumstances, it demonstrates dramatically that stroke can be treated. While the Australian Streptokinase (ASK) Trial²reported in this issue of THE JOURNAL was stopped early, it adds to the growing evidence that prompt intervention makes a difference in stroke. Unlike a cardiac arrest, in which brain viability is counted in minutes, early ischemic stroke harbors a dynamic mixture of salvageable tissue offering therapeutic windows lasting for hours.³The earlier the intervention, the better the prognosis; time is brain.⁴Similarly, the sooner thrombolytics are given, the better the chance for arterial recanalization and the lower the risk of complications.⁵This was a prior hypothesis and a finding of the ASK Trial, which suggested a beneficial effect in patients treated with streptokinase within